ChecklistGuro logo ChecklistGuro Solutions Industries Company Pricing

Healthcare Infection Control Checklist: Prevention & Protocol

Minimize hospital-acquired infections & ensure patient safety with our comprehensive Healthcare Infection Control Checklist. This essential resource guides your team through critical prevention protocols, regulatory compliance, and best practices for a safer healthcare environment. Download now & strengthen your infection control program!

This Template was installed 3 times.

Hand Hygiene Compliance

1 of 10

Ensuring proper handwashing and sanitizing techniques are followed consistently.

Last Hand Hygiene Time

Hand Hygiene Method

Duration of Handwashing (seconds)

Areas Touched During Hand Hygiene

Observation Notes (if applicable)

Observer Signature

Personal Protective Equipment (PPE) Usage

2 of 10

Verification of appropriate PPE selection and application based on risk assessment.

Type of PPE Used (e.g., Gloves, Gown, Mask, Eye Protection)

Correct Glove Size Selected?

Number of Masks/Respirators Available

Date of Last PPE Inventory Check

Areas/Tasks Requiring Specific PPE

Any Deviations or Concerns Regarding PPE Usage?

Photograph of Proper PPE Usage (Optional)

Environmental Cleaning & Disinfection

3 of 10

Monitoring of cleaning protocols for surfaces, equipment, and patient rooms.

Date of Cleaning

Time of Cleaning

Cleaning Product Used

Areas Cleaned (Be Specific)

Contact Time (in minutes)

Surfaces Disinfected

Cleaner Signature

Sterilization & High-Level Disinfection

4 of 10

Verification of processes for surgical instruments and reusable medical devices.

Cycle Load Number

Sterilization Date

Sterilization Start Time

Temperature (Internal)

Pressure

Exposure Time (Minutes)

Cycle Type

Sterilant Used

Cycle Printout/Record

Waste Management & Disposal

5 of 10

Compliance with regulations for handling and disposing of infectious waste.

Date of Waste Generation

Waste Category

Estimated Waste Volume (liters/gallons)

Description of Waste Contents (e.g., type of medication, specific biohazard)

Container Type

Waste Generator Signature

Waste Collection Point

Patient Isolation Procedures

6 of 10

Adherence to guidelines for isolating patients with communicable diseases.

Isolation Type

Reason for Isolation

Patient Room Number

Isolation Start Date

Isolation Start Time

PPE Required (Select all that apply)

Specific Isolation Instructions

Employee Health & Vaccination

7 of 10

Tracking employee vaccinations and health screenings to prevent transmission.

Last Tdap Vaccination Date

Last MMR Vaccination Date

Last Varicella (Chickenpox) Vaccination Date

Hepatitis B Vaccination Status

Number of Influenza Vaccinations Received (this year)

TB Screening Status

Upload Vaccination Records (optional)

Any Known Allergies Related to Vaccines?

Surveillance & Reporting of Infections

8 of 10

Monitoring infection rates and reporting to relevant authorities as required.

Date of Infection Detection

Patient Age

Infection Type

Description of Symptoms & Findings

Confirmed/Suspected

Number of Cases (if outbreak)

Date of Reporting to Public Health Agency

Education & Training of Staff

9 of 10

Ensuring all staff receive regular training on infection control practices.

Last Training Date

Training Module Completed (Select All)

Hours of Training Completed (Total)

Summary of Key Training Points

Upload Training Certificate/Record

Trainer Name

Equipment Maintenance & Calibration

10 of 10

Regular maintenance and calibration of infection control equipment.

Last Calibration Date

Calibration Result (e.g., Reading)

Acceptable Range (Lower Limit)

Acceptable Range (Upper Limit)

Calibration Status

Calibration Notes/Observations

Calibration Report (Optional)

Next Calibration Due Date

We can do it Together

Need help with Checklists?

Have a question? We're here to help. Please submit your inquiry, and we'll respond promptly.

Email Address
How can we help?